While many members had hoped for a more robust and less expensive dental insurance plan, most retirees view the new contract with Altus Dental as a positive step. Altus, which is an offshoot of Delta Dental, is headquartered in Providence, RI.

As we reported in March, the three-year contract with Altus is the direct result of a recently completed feasibility study, created by the Association, which was conducted by the GIC last year. The study showed a high interest in dental coverage, but an inability of most retirees to afford expensive monthly premiums.

Since the plan is retiree pay-all, with no state contribution, it was important to keep the monthly premiums affordable. At the same time, the GIC has made certain that major dental procedures are included within the plan.

“From the calls we are getting, it is clear that a great deal of interest exists in this plan. Most members understand that there were constraints on what could be offered and that it had to be affordable,” said Association Insurance Coordinator Cheryl Stillman. “Members should take the time to look over the material from Altus, attend one of the health fairs, and determine if the plan will meet their needs.”

Since the contract was awarded to Altus in January, the company and the GIC have kept in close contact with the Association. This working relationship has helped craft the plan in response to the input of retirees.

“Altus is pleased to have this contract and is really going the extra mile to make sure it is a successful launch in July. Success depends largely on enrollment and enrollment depends on the quality of the plan,” explains Association Legislative Liaison Shawn Duhamel. “Since the plan is not inexpensive, retirees need to believe that it is worth spending the extra money for the coverage.

“To their credit, Altus has already expanded the coverage by creating a network of dentists within Massachusetts. If you decide to see one of these dentists, then the price will be substantially reduced.”

Retirees enrolled in the Altus plan will have two options to consider when seeking dental care. As was explained in the March edition of the Voice, retirees will be able to see the dentist of their choice and will be provided with a set reimbursement for various dental procedures. For instance, the reimbursement for a root canal therapy on a molar is $325, leaving the retiree to pay the balance.

However, by seeing a dentist enrolled in the Altus network, the retiree will be provided with a reduced fixed rate and the Altus share of the cost will be paid directly to the dentist. Therefore, retirees visiting in-network dentists would not have to seek reimbursement from Altus.

“While it is very important for our members to have the freedom to seek care outside of the network, it is equally important to have a network in place to help lower costs,” continued Duhamel. “Again, members should carefully examine the list of dentists in the network and consider seeking their care through that dentist if it is possible. Altus is also in the process of recruiting more dentists to join the network, so inform your dentist of the option to enroll.”

In order to participate in the new dental plan, retirees must enroll during the annual open enrollment period, which extends this year to May 10. Coverage would then begin July 1, with access to Type III Services (i.e., extractions, root canals, crowns, and dentures) beginning six months later, on January 1, 2003.

It is common amongst dental insurance plans to institute a six-month waiting period before major procedures, like Type III Services, are covered. Another provision of the contract prohibits retirees who drop the plan from ever rejoining the plan.

Members, who choose to enroll in the plan, will pay a monthly premium of $32.36 for an individual and $77.16 for a family. The maximum annual benefit per person is $750.

Once enrolled, Altus Dental pays a set dollar amount for covered services. The retiree then pays the difference between the Altus payment and the dentist’s fee. A list of covered services has been mailed to all 77,000 eligible retirees and survivors. Most major dental procedures are covered, with the exception of orthodontic care.

It should also be noted that the GIC has created a discount vision program through Davis Vision. Under the plan, retirees can purchase vouchers good for examinations, eye care, and eye ware. Details of the voucher plan can be found in the GIC Benefit Decision Guide, recently mailed to GIC members.

For more details, you can contact Altus Dental directly at 1-800-722-1148 or on the web at www.altusdental.com.

Members should note that seeing a dentist in the Altus network will lower the out-of-pocket cost. Also, you are encouraged to seek pretreatment estimates prior to having dental work done.